Individual
DR. MICHAEL DREW LASALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA05925200
NJ
208800000X
Urology Physician
Primary
25MA05925200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223600796
AETNA,HORIZON
NJ
01
—
P1076991
OXFORD
NJ
Enumeration date
10/02/2006
Last updated
05/01/2024
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